Biomedical Ethics

In philosophy, the word ‘argument’ refers to an emotional dispute without supporting reasons.

False
An argument is a patterned set of statements in which at least one statement provides support for another statement.

A statement is the same thing as a sentence.

False
A statement (also called a “proposition”) is an assertion that something is or is not the case (or true). Statements or propositions are not the same kind of thing as sentences. Some sentences do not express statements (as defined above), some do, and some express more than one statement.

The supporting statements in an argument are called premises.

True

Valid arguments always have true conclusions.

False

A thesis is the main conclusion of an argument or series of arguments.

True

The use of moral norms and concepts to resolve practical moral issues is called

Applied Ethics

A key feature of moral norms is

normative dominance

A moral principle that applies in all cases unless an exception is warranted is

Prima Facie

The overriding of a person’s actions of decision-making for his or her own good is

paternalism

A principle of respect for autonomy places no restraints on what can be done to an autonomous person

False

Nonmaleficence is the bedrock precept of codes of conduct for health care professionals

true

That equals should be treated equally is a basic principle of autonomy

False

Moral absolutism is the view that there are moral norms or principles that are valid or true for everone

False

From the fact that cultures have divergent moral beliefs on an issue, it does not logically follow that there is no objective moral truth

True

Cultural relativism logically entails tolerance for other cultures

false

If people’s moral judgments differ from culture to culture, moral norms are relative to culture

False

Cultural relativism implies that we cannot legitimately criticize other cultures

true

All religious people accept the divine command theory

false

Logical argument and persuasion are essentially the same thing

false

A deductive argument is intended to give

Logically conclusive support to its conclusion

The misinterpretation of a person’s views so they can be more easily attacked or dismissed is known as

The straw man fallacy

Moral Premises can be called into question by showing that they

Conflict with credible principles, theories, or judgments

In assessing an argument, the first order of business is to

Find the premises

The argument form of “If p, then q; therefore q” is called

modus ponens

A moral theory explains

Why an action is right or wrong or why a person or a person’s character is good or bad

Consequentialist moral theories insist that the rightness of actions depends solely on

Their consequences or results

Act-utilitarianism is the view that

The rightness of actions depends solely on the relative good produced by individual actions

Kant says that through reason and reflection we can derive our duties from

The categorical imperative

Natural law theory is the view that right actions are those that conform to moral standards discerned in nature through human reason.

True

Natural law tradition resolves dilemmas through the principle of utility.

False

Rawls’s equal liberty principles says that each person is to have an equal right to the most extensive total system of equal basic liberties compatible with a similar system of liberty for all.

True

According to virtue ethics, the central task in morality is knowing and applying principles.

False

In the ethics of care, the heart of the moral life is feeling for and caring for those with whom you have a special, intimate connection.

True

Moral theories are not relevant to our moral life

False

Rule-utilitarianism is the idea that the rightness of actions depends solely on the relative good produced by individual actions.

False

Classic utilitarianism depends heavily on a strong sense of impartiality.

True

Kant’s categorical imperatives are absolutist.

True

Kant’s principle of respect for persons says that we should always treat persons

Never merely as a means to an end

Underlying natural law theory is the belief that

All of nature, including humankind, is teleological

The data that a moral theory is supposed to explain are

Our considered moral judgments

Any moral theory that is inconsistent with the facts of the moral life is

Problematic

Paternalism directed at persons who cannot act autonomously or whose autonomy is greatly diminished is known as

Weak paternalism

The case of Helga Wanglie concerned what some have referred to as

Medical futility

Weak paternalism is not usually considered an objectionable violation of autonomy.

True

Physicians are obliged to regard every patient request as legitimate.

False

According to Roman Catholic doctrine, a hopelessly ill patient has the right to refuse extraordinary life-sustaining treatments.

True

Early medical practice was strongly paternalistic.

True

A person is either fully autonomous or entirely lacking in autonomy

False

The traditional notion of a nurse is that of a care-giver subordinate to physicians and duty bound to carry out their directives for patient care and treatment. For many nurses this model seems fraught with conflicts between _____.

The nurse’s obligation to follow doctor’s orders and her duty of beneficence toward her patients

Some reject the traditional model of nursing, arguing instead that the nurse’s ultimate responsibility is to be _____.

An advocate for patients

In general, Kantian ethics views paternalism as

A violation of autonomy

In six to eight lines, explain why Goldman thinks that autonomy or self-determination is independently valuable and what relevance this has when considering the permissibility of medical paternalism.

Goldman argues that strong paternalism is only justifiable in very few extraordinary cases. He believes that patients have the freedom to make their own choices (autonomy/ self-determination). The faulty argument of strong paternalism is the assumption that prolonged life is always the top priority for a patient, however not everyone has the same priorities. He believes that overall people have “the right to be told the truth about ones condition, and the right to accept or refuse or withdraw from treatment on the basis of adequate information regarding alternatives, risks, and uncertainties”.

In six to eight lines, identify Ackerman’s thesis and summarize his argument.

Ackerman believes that respect for patient autonomy can be distorted if it is only understood as noninterference. He feels like the view of “doctor[s] need be only an honest and good technician, providing relevant information and dispensing professionally competent care” doesn’t genuinely respect the idea of autonomy. He claims it doesn’t recognize the fact that autonomy is made up of many factors like illness or other types of restraints. He feels the ultimate goal should be to “resolve underlying physical (or mental) defects, and deal with cognitive, psychological, and social constraints to restore autonomous functioning.”

According to Emanuel and Emanuel, the main emphasis of the paternalistic model of the physician-patient relationship is on the patient’s freedom of choice.

False

Which model of the physician-patient relationship conceives of physicians as technicians who are supposed to carry out their patient’s clearly defined wishes without imposing their own values on their patients?

The informative model

According to Emanuel and Emanuel, one problem with the informative model is that patients do not in fact typically possess known and fixed values that would easily determine their choices regarding their medical care.

True

Emanuel and Emanuel conclude that the interpretative model best promotes patient autonomy, which should be understood to involve more than unreflective choice free from coercion.

False

The action of an autonomous, informed person agreeing to submit to medical treatment or experimentation is known as

Informed consent

The ability to render decisions about medical interventions is known as

Competence

The patient’s voluntary and deliberate giving up of the right of informed consent is called

Waiver

The withholding of relevant information from a patient when the physician believes disclosure would likely do harm is known as

Therapeutic privilege

A credible and severe threat of harm or force to control another has been called

Coercion

Incompetence does not come in degrees.

False

In the 1970s, courts began to insist that the adequacy of disclosure should be judged by what patients themselves find relevant to their situation.

True

Informed consent requires that patients understand all information given to them.

False

Some theorists have defined informed consent as autonomous authorization.

True

The requirement of informed consent can be derived directly from Kantian ethics.

True

Philosophers have justified informed consent through appeals to the principles of autonomy and beneficence.

True

Many critics see huge discrepancies between the ethical ideal of informed consent and the laws or rules meant to implement it.

True

Usually patients are presumed to be competent unless there are good reasons to think otherwise.

True

Patients are legitimately judged incompetent in cases of

Mental retardation and dementia

The consent of an informed, competent, understanding patient cannot be legitimate unless it is given

Voluntarily

In “Whose Body Is It Anyway?” Atul Gawande maintains that sometimes patients make bad choices that conflict with their deeper interests and that in such cases it is the responsibility of a physician to not simply accept a patient’s initial decision.

True

Gawande argues that the present emphasis on patient autonomy is misguided and that the old days of paternalistic medicine were better.

False

Gawande argues that it is always possible to formulate in a rule-like and principled way how a physician should act when it comes to matters of respect for patient autonomy.

False

Gawande explains that when it came to deciding whether or not to have his daughter, Hunter, intubated and put on a ventilator, he chose to let the physicians in charge of her decide.

True

In the final story that Gawande recounts, a patient, named Mr. Howe, explicitly says he does not want to be put on a machine and as a result dies because the physician in charge respects Howe’s wishes.

False

Faden and Beauchamp distinguish two senses of informed consent. In six to eight lines, identify the two senses and explain the relationship between the senses according to these authors.

Sense 1 is “informed consent” focussed primarily on the respect for autonomous authorization. It is being informed of the situation and authorizing a professional to continue in the way the patient sees fit. Sense 2 is “informed consent” that also follows the rules and regulations set forth by an institutuon in the context of the situation. In some cases, consent can pass sense 1 if the person is aware of the situation and chooses to authorize a procedure and can still fail sense 2 if it does not follow the rules set forth (Faden and Beuchamp, 192). The example in the book is that of a minor consenting to a kidney transplant with full understanding of the situation, however it must also go through her parents per the rules of the institution; therefore sense 1 was met but not sense 2.

In “Abandoning Informed Consent,” Veatch sets out to show why the concept of “informed consent” should be abandoned in favor of the older paternalistic approach to medicine.

False

Veatch argues that when suggesting a plan of treatment that is in the best interest of the patient, a clinician must be able to perform all of the following tasks EXCEPT:

Offer the patient as wide a range of treatment options as possible.

Veatch argues that if a clinician cannot be expected to be able to reliably guess at what is in the best interest or the medical interest of the patient, then the patient cannot rationally consent to the recommendation.

True

A key premise in many arguments against abortion is that

The unborn is an innocent person from the moment of conception

Mary Anne Warren identifies five traits that are “most central” to personhood and declares that a fetus

Has none of these traits

Some people opposed to abortion argue that the fetus is a potential person and thus has the same right to life as any existing person.

True

Both liberals and conservatives on the abortion issue agree that murder is wrong and that persons have a right to life.

True

Most Western industrialized countries have lower abortion rates than the United States does.

True

The risk of death associated with abortion performed at eight weeks or earlier is _____.

One death per 1 million abortions

Conservatives on the abortion issue charge that liberals’ standards for personhood imply that

Cognitively impaired individuals are not persons

Warren comes up with five criteria for personhood by…

Considering what characteristics we would look for if we were trying to determine something on another planet was a person

Warren acknowledges that her criteria for personhood suggest that newborns are not persons.

True

Warren thinks that it is equally wrong to kill entities that strongly resemble persons and potential persons as it is wrong to kill actual persons.

False

Which of the following is a reason that Warren provides for thinking that infanticide of newborns is wrong?

Someone may want the newborn.

Lee and George argue that abortion should be illegal.

False

Lee and George acknowledge that the human embryo is not genetically distinct from cells of the mother or of the father.

False

Lee and George argue that the human embryo is a complete human being because it is fully programmed actively to develop to the mature stage of a human being.

True

Lee and George define persons to be a distinct subject with the natural capacity to reason and make free choices and argue a human embryo is a person though it is not able to actualize its natural capacities.

True

Lee and George draw a distinction between rights that depend on circumstance and fundamental rights that makes one the sort of entity capable of having rights that depend on circumstance.

True

Lee and George argue that a human embryo is accidentally a person, which means that it is substantially something else but that it may develop the characteristics that make it temporarily a person.

False

George and Lee give three reasons for thinking that it is a mistake to require that an entity possess an immediately (or nearly immediately) exercisable capacity to engage in higher mental functions in order to be worthy of full moral respect including a right to life. Which one of the following is not one of those reasons?

Those who are in a reversible coma or asleep are not immediately capable of higher order mental functions.

Lee and George argue that a human embryo possesses the capacities characteristic of persons in virtue of.

The kind of thing it is

In “A Defense of Abortion,” Thomson argues that all abortions are morally impermissible.

False

Thomson’s primary purpose in the article is to demonstrate that the fetus is not a person.

False

Which of the following “thought experiments” does Thomson NOT use in order to make her case?

You are a space traveler and visit another planet where you must distinguish persons from non-persons.

Thomson argues that we act unjustly if we do not always behave like Good Samaritans.

False

Thomson suggests that many of her thought experiments show that a pregnant woman has a right to secure the death of the unborn child.

False

Thomson argues that “having a right to life” actually means:

Having a right to not be killed unjustly

The full version of the people-seed thought experiment is meant to parallel what situation associated with pregnancy?

consensual sex with protection

Lee and George respond to the sort of argument put forward by Thomson where morally permissible abortion is conceived of as choosing to expel or evict the fetus rather than choosing to kill it.

True

George and Lee accept that some abortions do not consist in intending the fetus’s death (either as means or an end) but instead involve a choice to expel the fetus, the fetus’s death being an foreseen consequence of this action.

True

One way that George and Lee distinguish between abortion as intentional killing and as non-intentional killing is by considering whether the pregnant woman and physician performing the abortion would consider the abortion a success if somehow the fetus survived.

True

Lee and George argue that while intending someone’s death is always wrong, causing death as an unintended side effect is always morally permissible.

False

Lee and George’s example of a man who continues to smoke in the presence of his daughter whom he has been informed has a serious respiratory disease of the sort that if he continues to smoke in her presence it will cause her death is given as an example of…

unjustly causing the death of someone as an unintended side effect

What do Lee and George think should be concluded in light of the following case?

“But suppose a mother takes her baby home after giving birth, but the only reason
she did not get an abortion was that she could not afford one. Or suppose she lives
in a society where abortion is not available (perhaps very few physicians are willing
to do the grisly deed). She and her husband take the child home only because
they had no alternative. Moreover, suppose that in their society people are not waiting
in line to adopt a newborn baby. And so the baby is several days old before anything
can be done. If they abandon the baby and the baby is found, she will simply
be returned to them” (Lee and George, 22).

that parental responsibility exists even when it is not voluntarily assumed or explicitly consented to

Lee and George argue that biological parents have special moral responsibilites to provide for the needs of their children because of the special form of physical continuity or union they share with their children.

True

Marquis argues that in most cases abortion is morally impermissible because the fetus is a person

False

Marquis argues that in order to make progress in the abortion debate it is necessary to first clearly determine why it is generally wrong to kill an adult human being.

True

Marquis argues that the primary reason why killing is wrong is because it brutalizes the killer.

False

Marquis argues that what is a greatest value that is lost when some one is killed is not the person’s biological life but their future life of experiences, activities, and projects that give life value and significance.

True

Because Marquis assumes that one must value something in order for it to be valuable, he concludes the since a fetus does not value its future, its future is not valuable.

False

In response to the objection that his account of the wrongness of killing would imply not only that abortion but also that contraception is immoral, Marquis replies that abortion and contraception are not morally equivalent because in the case of contraception…

there is no nonarbitrary indentifiable subject of the loss of a future

Performing an action that directly causes someone to die—what most people think of as “mercy killing”—is called

active euthanasia

Those who oppose euthanasia often draw a sharp distinction between

Killing and letting die

Some argue against active voluntary euthanasia by advancing a distinction between intending someone’s death and not intending but foreseeing it.

True

According to Oderberg, the principal argument for voluntary euthanasia is:

All rights are alienable; there is a right to life; therefore, the right to life is alienable.

According to Oderberg, proponents of voluntary euthanasia often make a comparison between the right to life and the right to property to show that the right to life, like the right to property, is…

alienable

One problem with the property-life analogy according to Oderberg is that…

While it is possible to alienate oneself from a particular piece of property, alienating oneself from the right to possess property in general is not possible and this is what would be required if the analogy were to hold between the right to life and the right to own property.

Oderberg suggests that a Kantian view of autonomy with its ethical restraints has been replaced in the debate over euthanasia (and the wider culture) by the idea the will must be allowed to range freely over whatever ends a person deliberately chooses as integral to his ‘personal fulfillment”.

True

Which of the following is not one of the possible responses that Oderberg identifies in response to the argument supporting euthanasia that “we not treat a dog like that” (putting it down instead of keeping it alive).

There are problems with drawing a comparison between animals and humans because animals cannot provide informed consent.

Oderberg argues that it is incoherent to claim that killing a human being can be good for the person being killed because euthanasia fails to improve the person’s condition.

True

Quill was troubled by Diane’s decision to refuse further treatment.

True

At Diane’s request, Dr. Quill prescribed barbiturates for Diane and made sure she understood the amount she need to commit suicide.

True

Dr. Quill reported the cause of Diane’s death as an involuntary overdose of barbiturates

False

Brock argues that the right to respect for autonomy extends to the right to choose the time and manner of one’s death.

True

Brock argues that control of death is good because at the end of life people often experience a loss of control and loss of their mental and physicial capacities. Giving individuals control over the way they die enables them to retain some control over their lives.

True

Brock argues that both the value of self-determination and the value of individual well-being provides support for physician assisted suicide and voluntary euthanasia.

True

Brock maintains that it is not possible for an individual to competently judge whether their life is no longer worth living.

False

Brock considers and rejects the objection that euthanasia is wrong because it involves the deliberate killing of an innocent person.

True

In reply to the objection that euthanasia is wrong because it is a form of intentionally killing, Brock replies that not all forms of intentionally killing is wrong since withdrawing life support is a form of intentional killing

True

Brock argues that in the case of euthanasia a person is being deprived of a valuable future

False

Brock argues that since in the case of voluntary euthanasia a person has waived their right to live it cannot be objected that euthanasia is wrong because it violates their right to life.

True

Killing by omission is considered equally wrong as killing by comission, according to Oderberg, when one has a prior duty to act, which one neglects, such as when a mother fails to feed her children and they starve to death.

True

Oderberg claims that there is, morally speaking, a signficant difference between(1) a failure to cure an infection in a terminally ill patient, where the failure involves the intention that the patient should die, and (2) a lethal injection to hasten the death of such a patient.

False

Oderberg argues that in settling questions about the ethics of euthanasia the best approach to take is to follow what is accepted as standard medical practice.

False

Oderberg argues that as long as a death is merely a foreseeable cause of one’s action or inaction and not intended, then it is morally permissible.

False

Oderberg maintains that what interventions count as extraordinary means is something that stays the same over time despite advances in medical technology and other relevant changes.

False

Oderberg argues that the shift to a whole-brain criteria for death was motivated primarily by objective scientific findings.

False

Oderberg suggests that the Nazi euthanasia program to destroy those unworthy of life is consistent with the principles of modern consequentialist bioethics.

True

The theory of justice insisting that the benefits and burdens of society should be distributed through the fair workings of a free market and the exercise of liberty rights of noninterference is

libertarian

Norman Daniels believes that a strong right to health care can be derived from the principle of

Fair equality of opportunity

The utilitarian purpose behind using quality-adjusted life years (QALYs) is

To do the most good with the resources available

Some argue that QALYs are unfair to

older people and the disabled

Utilitarian theories of justice affirm that important benefits and burdens of society should be distributed equally.

False

Although the United States spends more on health care than any other country, the quality of the care is not obviously better overall than that of other countries.

True

A right to health care is considered a positive right.

True

The theory of justice most likely to insist on a system of universal health care is

egalitarianism

Engelhardt argues that access to health care is a basic human right shared by all.

False

Engelhardt argues that because their is considerable consensus about what the good life consists in and what is just it is possible to make progress in determining what people owe one another with regards to providing access to health care.

False

Engelhardt argues that there are only two conditions under which a person has a just claim to another’s property: (1) when the original property holder has consented to transfer ownership to another and (2) when the original property owner has harmed another and must make restitution for the injury.

True

The social lottery consists in changes in fortune that result from natural forces, not directly from the actions of persons.

False

Daniels defines health as functioning normally for some appropriate reference class of a species.

Daniels argues that we do not have a social obligation to protect the opportunity range open to individuals unless we have explicitly promised to do so.

False

Daniels draws from Rawls’ contractarian approach to determining what is just as a basis for supporting premises in his argument.

True

Daniels concludes that providing health care to others meets our social obligations to protect the opportunity range of individuals.

True

Buchanan argues that everyone is entitled to some minimal level of health.

False

Buchanan defines having a right to something in terms of being entitled to it or it being due to a person.

True

A universal right is one that applies to particular people because of their involvement in special actions, relationships, or agreements.

False

Buchanan maintains that the concept of a right to a decent minimum of health care can serve as an adequate basis for coercively backed decent minum policy in the absence of a coherent and defensible theory of justice.

False

Buchanan argues that giving from beneficence toward particular programs that provide health care might be justifiable enforced in order to effectively coordinate charitable efforts in such a way that will produce the desired benefit.

True

Buchanan thinks the special rights of particular groups of individuals and the duty to prevent harm are relevant for providing a basis for a moral requirement to provide access to health care to others.

True

In “Medical Professionalism and the Care We Should Get” Daniels argues who a physician is obligated to provide care for is determined by the very concept of professionalism.

False

In “Medical Professionalism and the Care We Should Get” Daniels argues that the scope and content of professional ethics for physicians should be constrained by the demands of justice.

True

Which one of the following is an example of the sort of “moral exceptionalism” that is said to be characteristic of the medical profession:

that physicians should provide care for patients even if this exposes physicians to considerable risks

In “Medical Professionalism and the Care We Should Get” Daniels argues that a look at the history the way the medical profession in the United States acquired societal power and professional autonomy supports the view that such power and autonomy was guided primarily by a concern for justice.

False

Which model of the physician-patient relationship conceives of physicians as technicians who are supposed to carry out their patient’s clearly defined wishes without imposing their own values on their patients?

The informative model

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